| NPI | 1710528237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA EMIL JIMENEZ Owner 813-503-3652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2019-10-06 |
| Last Update Date | 2021-04-21 |